brivaracetam / Generic mfg. - LARVOL DELTA

Association of Aggression and Anti-seizure Medications in Pediatric Patients: Disproportionality Analysis Using the FDA Adverse Event Reporting System. (PubMed, Eur J Pharmacol) - "Signals of aggression related to different ASMs were identified. Significantly strong signals were observed for perampanel, levetiracetam and brivaracetam. Compared to infants and preschooler, ASMs-associated aggression is more common in school children and teenagers."

Adverse events • Journal • CNS Disorders • Epilepsy • Pediatrics

Economical chiral and achiral separation of seven impurities in brivaracetam by supercritical fluid chromatography with polysaccharide-based chiral stationary phases. (PubMed, J Pharm Biomed Anal) - "Moreover, the developed SFC method outperformed the reference methods from the European Pharmacopoeia in terms of analysis throughput and environmental friendliness. This study serves as a reference for the development of efficient and environmentally sustainable impurity analysis methodologies for drugs with multiple chiral centers."

Journal

EpiTrack: Direct and indirect role in the assessment of executive functions and memory - Systematic review. (PubMed, Appl Neuropsychol Adult) - "Perampanel and Cenobamate exhibited a neutral cognitive profile, with scores stable at "moderate impairment" (29.67-30.04). Lamotrigine and Levetiracetam demonstrated persistent severe impairment. Brivaracetam improved from severe to moderate impairment (not clinically significant). Only Topiramate showed a clinically significant decline (30.0 to 26.6)...In contrast, VNS with 3-4 AEDs maintained severe impairment. This review underscores the importance of accurate cognitive assessment in epilepsy management, with a monitoring frequency of no more than every six months for patients receiving AED therapy."

Journal • Review • Alzheimer's Disease • CNS Disorders • Cognitive Disorders • Epilepsy

Cenobamate in real world : a single center study (AES 2025) - "68 patients had a proactive decrease in one or several concomitant ASM dosage, mainly lacosamide (N=25), perampanel (N=14), clobazam (N=12). 51 patients needed a further decrease in other ASM dosage (mainly brivaracetam and lacosamide), and 52 patients could stop at least one concomitant ASM (mainly lacosamide and perampanel)... Efficacy of CNB is confirmed in this real world series of patients. After one year of follow up, the efficacy is maintained with 52% of the patients being either seizure free or responders. Side effects are common and in line with those found in regulatory studies."

Clinical • Real-world • Real-world evidence • Ataxia • CNS Disorders • Epilepsy • Movement Disorders

Cenobamate and Brivaracetam Use in Pregnancy and Lactation - A Case Report (AES 2025) - "She previously failed multiple ASMs, including clonazepam, gabapentin, oxcarbazepine, levetiracetam, lamotrigine, zonisamide, and phenytoin, due to inadequate seizure control or intolerable side effects. This case describes a normal pregnancy outcome in a young female with intractable localization-related epilepsy on combination cenobamate and brivaracetam. To our knowledge, this is the first reported pregnancy outcome with this specific ASM combination. This offers reassuring, preliminary evidence that cenobamate and brivaracetam may be safely continued in pregnancy when benefits outweigh risks, especially in intractable epilepsy."

Case report • Clinical • Anesthesia • CNS Disorders • Epilepsy

Multi-Night Analysis on the Effect of Epilepsy Medication on Sleep Spindles in Intracranial EEG (AES 2025) - "Each patient took between 1-4 anti-epilepsy medications, which included Lamotrigine, Topiramate, Cenobamate, Clobazam, Oxcarbazepine, Briviact, Carbamazepine, Lacosamide, and Zonisamide. This preliminary analysis into muti-medication effects on sleep spindles during a multi-night EMU stay with intracranial EEG, suggests that there could be a relationship between anti-epilepsy medication dosages and sleep spindle rates. If confirmed in a larger cohort, the observed increase in sleep spindle rate with higher medication doses might suggest a positive effect of medication on sleep. This could be an indirect consequence of the decrease in epileptiform activity, which might permit the augmentation of sleep spindles even outside the seizure onset zone."

CNS Disorders • Epilepsy

History of the Racetams. (AES 2025) - "Funding: None Rationale: Levetiracetam (LEV) has been a blockbuster drug and drew attention to a unique mechanism of action. The history of antiseizure medication (ASM) discovery provides lessons for new drug development. We reviewed literature and conducted interviews with the investigators involved. Piracetam was synthesized in 1964 by Giurgea in a project attempting to develop GABA analogues for use in sleep induction...Gower noted that while LEV was only weakly effective in the more common maximal electric shock (MES) and pentylenetetrazole (PTZ) models, it was surprisingly effective as an anticonvulsant in an audiogenic mouse model...Seletracetam and brivaracetam (BRV) were both synthesized and BRV was chosen as more promising for clinical development based on effectiveness in MES and PTX models as well as the audiogenic mouse model... LEV would not have been discovered if only standard screening models were used. New screening methods may help identify new ASMs.New..."

Absence Seizure Disorder • CNS Disorders • Epilepsy • Movement Disorders • Psychiatry

Rare Case Study of Unverricht-Lundborg Disease in Two Siblings: Insight to Genetics and Phenotypic Expression (AES 2025) - "The current regimen includes clonazepam, valproic acid, felbamate, brivaracetam, and cannabidiol. The younger sibling also requires zonisamide... In cases of stimulus-induced myoclonus, progressive GTCs, and ataxia with cognitive decline, clinicians should consider Progressive Myoclonic Epilepsy type 1 (ULD) and confirm with genetic testing. Antiepileptic polytherapy is required. While stimulus-sensitive myoclonic jerks can be resistant, GTCs may respond favorably to treatment."

Case study • Clinical • Ataxia • CNS Disorders • Depression • Epilepsy • Gastrointestinal Disorder • Movement Disorders • Psychiatry

Extending Epilepsy and Pregnancy Registers: A Pilot in The UK Epilepsy and Pregnancy Register to Include Routine Longitudinal Child Follow Up (AES 2025) - "These numbers included rarer ASM exposures such as clobazam, cenobamate, zonisamide, lacosamide and brivaracetam. A dual model of both surveillance and enhanced investigations offers the opportunity to routinely collect screening level child health and neurodevelopmental outcome data across large geographical regions, alongside more enhanced researcher-led data collection for subpopulations. Implementing longitudinal routine child health and neurodevelopmental investigations into already established initiatives such as Epilepsy and Pregnancy Registers will improve available data regarding the safe use of ASMs in women of reproductive age."

Clinical • CNS Disorders • Epilepsy

Tolerability and Efficacy of Adjunctive Brivaracetam in Japanese and Chinese Patients With Focal Seizures: Phase 3, Open-Label Extension Trial (AES 2025) - P3 | "Long-term adjunctive BRV 50–200 mg/day was well-tolerated and efficacious in Japanese and Chinese patients with focal seizures. No new safety signals were observed."

Clinical • P3 data • CNS Disorders • Epilepsy

Safety of Brivaracetam among Hospitalized Patients with Severe Renal Dysfunction (AES 2025) - "BRV appears to be safe when used in this population of patients with severe renal dysfunction, including those patients on hemodialysis. While somnolence with BRV is reported to be approximately 18% in published studies, this study showed a higher rate of about 29%; however, our study population was small, had higher acuity (39% in status epilepticus), and was significantly older than published literature. This was the first study to evaluate the use of brivaracetam in ESRD patients."

Clinical • Chronic Kidney Disease • CNS Disorders • Epilepsy • Nephrology • Renal Disease

Accuracy of Patient Seizure Reporting (AES 2025) - "Furthermore, some drugs (Brivaracetam, Lyrica) performed both poorly and successfully in separate studies, raising doubt in the accuracy of patient reporting.Previous studies have already shown patient reporting to be unreliable, but there is room for improvement and clarification. Patient seizure reporting is inaccurate and should not be used as the sole or primary basis to determine effective treatments or the outcome of clinical trials. Multi-faceted approaches to monitoring - technology detecting motion, autonomic function, and other body characteristics - along with ambulatory EEG data may prove to be the most reliable."

Clinical • CNS Disorders • Epilepsy

Intranasal Diazepam as Preventive Therapy in Drug-Resistant Catamenial Epilepsy (AES 2025) - "All her seizures had perimenstrual exacerbations, but the effect was most pronounced for absence seizures (Day 9 of menstrual cycle) and GTCs (Days 6 to 9 of menstrual cycle.) The patient's seizures were resistant to brivaracetam, lamotrigine, topiramate, cannabinoid at high doses and VNS at maximal settings...She had also failed pulsed clonazepam and acetazolamide for control of catamenial seizures... This case demonstrates the potential effectiveness of scheduled intranasal diazepam as a targeted preventive strategy for catamenial epilepsy. Intranasal diazepam has a prolonged half-life of > 24 hours that facilitates once daily administration.3 By anticipating the predictable timing of seizure clusters in relation to the menstrual cycle, prophylactic administration of diazepam significantly reduced seizure frequency with seizure freedom of absence seizures and GTCs. Tolerance to diazepam and withdrawal seizures are possible adverse effects."

Absence Seizure Disorder • CNS Disorders • Epilepsy

Safety of Brivaracetam During Pregnancy: A Case Report. (AES 2025) - "The most commonly used ASM during pregnancy includes Lamotrigine, Levetiracetam, and Oxcarbazepine, as shown in comparative studies by Cerulli Irelli et al. BRV is FDA approved for focal epilepsy for 1 month and older. This case report is unique since our pregnant patient had generalized epilepsy. So far, our case and case series by Paolini et al."

Case report • Clinical • Cardiovascular • CNS Disorders • Epilepsy • Gynecology • Hypertension

Epilepsy-Related and All-Cause Healthcare Resource Utilization After Initiation of Adjunctive Cenobamate (AES 2025) - "The aim of this study was to evaluate the comparative effect of initiating cenobamate vs selected ASMs (brivaracetam, clobazam, eslicarbazepine, lacosamide, or perampanel) on epilepsy-related and all-cause inpatient (IP) and emergency room (ER) utilization rates. A retrospective observational study using de-identified electronic health records (EHRs) from 28 healthcare organizations representing ambulatory centers, hospitals, imaging centers, and clinics and medical offices (the Truveta database) identified adults (≥18 years) with an epilepsy diagnosis who initiated cenobamate or another selected ASM between January 1, 2020 and Dec 5, 2024. Initiation of cenobamate was associated with a significant reduction in both epilepsy-related and all-cause IP admissions and ER visits as compared to propensity-matched patients who similarly could likely have initiated cenobamate, but instead initiated other ASMs. The mechanism for why cenobamate was associated with fewer IP..."

HEOR • CNS Disorders • Epilepsy

Safety and Efficacy of Brivaracetam in Pediatric Epilepsy: A Systematic Review and Meta-Analysis (AES 2025) - "Recently, a novel anti-epileptic drug called Brivaracetam (BRV) was introduced that inhibits neurotransmitter release, with 15 to 30 times the affinity of Levetiracetam, and demonstrates a higher blood-brain barrier permeability. This study demonstrated that BRV usage for the treatment of epilepsy in a pediatric population is safe and effective. Further studies, including high quality randomized control trials are required to signify efficacy across various epilepsy classes and comparative beneficence over current gold-standard treatments."

Retrospective data • Review • CNS Disorders • Epilepsy • Pediatrics

Long-Term Safety, Tolerability, and Efficacy of Brivaracetam in Patients With Childhood Absence Epilepsy or Juvenile Absence Epilepsy (AES 2025) - P3 | "Long-term BRV was well-tolerated and potentially efficacious in patients aged 2-26 yrs with CAE or JAE, and the results were consistent with the overall BRV safety profile. Further studies, including the completion of the ongoing core Phase 3 trial N01269, are needed to confirm the efficacy of BRV for treating CAE and JAE."

Clinical • Absence Seizure Disorder • CNS Disorders • Epilepsy

Intra-nasal Seletracetam for reading epilepsy: a first in human proof-of-concept case study (AES 2025) - "Seletracetam (SEL) is a levetiracetam analogue with~100- and~10 greater potency than levetiracetam and brivaracetam, respectively, developed by UCB pharma to Phase 2 clinical stage, with good efficacy and safety profiles.[1] PrevEp, Inc. In this compassionate use case report, intranasal administration of a total of 60mg seletracetam fully prevented reflex seizures. A bitter taste after the first administration, but not the second, suggest that part of first 30mg dose was swallowed, and possibly explains that reading-induced seizures still occurred albeit with delayed onset and reduced spike-frequency. This case supports SEL's potential as the first non-benzodiazepine acute seizure treatment."

Case study • Clinical • First-in-human • P1 data • Anesthesia • CNS Disorders • Depression • Epilepsy • Psychiatry

Mortality Risk After Initiation of Cenobamate or Other Antiseizure Medications (AES 2025) - "The present real-world study examined the all-cause mortality rate in patients after initiating cenobamate vs the mortality rate in patients treated with selected antiseizure medications (ASMs) that have similar patterns of use in medication-resistant epilepsy. A retrospective observational study using de-identified electronic health records from 28 US health systems (Truveta) identified adults (≥18 years) with an epilepsy diagnosis who initiated therapeutic doses of cenobamate or another selected ASM (brivaracetam, clobazam, lacosamide, eslicarbazepine, or perampanel) between 1/1/2020-12/5/2024. This retrospective analysis shows that patients treated with cenobamate at therapeutic doses had lower mortality rates than patients treated with selected comparable ASMs commonly used for medication-resistant epilepsy. Further exploration of these results are needed to compare to other ASMs and non-ASM treatment options (e.g., surgery and neuromodulation), to compare to..."

CNS Disorders • Epilepsy

International Consensus on the Evaluation and Management of Hypothalamic Hamartomas: Results from a Modified Delphi Survey (AES 2025) - "Treatment: A plurality (not consensus) recommended oxcarbazepine/carbamazepine or levetiracetam/brivaracetam as 1st-line antiseizure medications (ASM). This Delphi process highlights an international consensus on aspects of HH management. Agreement included the importance of gelastic/dacrystic seizures. A 3T epilepsy protocol MRI is essential."

CNS Disorders • Depression • Epilepsy • Psychiatry

Exposure to Curriculum-Based Education Increases the Evidence-Based Use of Newer Anti-Seizure Medications for the Management of Focal Epilepsy Among Neurologists (AES 2025) - "Neurologist learners across the 3 CME programs were matched to claims data to identify them as prescribers of newer ASMs (defined as: brivaracetam, cenobamate, eslicarbazepine, lacosamide, and perampanel) in the 6 months prior to participation and 3 months after program participation relative to a propensity matched group of neurologists who did not participate in the educational programming. The reported data indicated that positive improvements in knowledge and competence across CME programming on the use of newer ASMs can translate to improvements in the clinical use of such medications. The next step is to determine if similar claims results are found 6 months after taking the CME programming."

CNS Disorders • Epilepsy

Experiences Reported by People with Epilepsy During Antiseizure Medication Shortages in the UK: A Cross-Sectional Survey. (PubMed, Pharmacy (Basel)) - "Shortages were most frequently reported for sodium valproate (60.8%), lamotrigine (65.2%), carbamazepine (92.6%), clobazam (82.6%), topiramate (81.5%), zonisamide (74.0%), levetiracetam (62.8%), lacosamide (71.0%), and brivaracetam (70.5%). (4) ASM shortages are a widespread issue for people with epilepsy in the UK, leading to treatment disruptions and psychological distress. Addressing supply change limitations and identifying effective approaches to preventing the substitution of ASMs brands by clinicians may potentially reduce this problem."

Journal • CNS Disorders • Epilepsy • Mood Disorders • Psychiatry

Clinical practice guidelines for the administration of third-generation anti-seizure medications. (PubMed, Seizure) - "This guideline provides a detailed evaluation of the current evidence and treatment recommendations regarding third-generation ASMs. This guideline will help clinicians to better understand these medications and offer guidance for clinical practice."

Clinical guideline • Journal • Review • CNS Disorders • Epilepsy

Economic evaluation of brivaracetam in the adjunctive treatment of patients with focal-onset seizure in Jordan. (PubMed, Medicine (Baltimore)) - "In addition to BRV, 3 treatment comparators were included in this economic evaluation: eslicarbazepine (ESL), lacosamide (LCM), and perampanel (PER). Compared to ESL and PER, BRV was associated with cost-savings. Compared to LCM, the BRV was cost-effective at the World Health Organization recommended willingness-to-pay threshold of 3× of Jordanian gross domestic product per capita."

HEOR • Journal • CNS Disorders • Epilepsy

Lacosamide is Associated with a Higher Treatment Persistence at 12 Months than Brivaracetam and Perampanel Despite Similar Efficacy. (PubMed, Neurol Ther) - "Treatment discontinuation in epilepsy emerges as a dynamic process shaped by both tolerability and clinical response. Early persistence was higher for LCM, whereas long-term retention was improved for BRV and PER. These results support a personalized approach to ASM selection that integrates early tolerability with sustained effectiveness."

Journal • CNS Disorders • Epilepsy